Provider Demographics
NPI:1861465452
Name:HEGERFELD, VICKI L (DC)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:L
Last Name:HEGERFELD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S WHITNEY WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-6274
Mailing Address - Country:US
Mailing Address - Phone:608-274-6200
Mailing Address - Fax:
Practice Address - Street 1:1001 S WHITNEY WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-6274
Practice Address - Country:US
Practice Address - Phone:608-274-6200
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2884 123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI391827287015OtherBCBS
WIU58318Medicare UPIN
WI70879Medicare ID - Type UnspecifiedMEDICARE